Jindal alters treatment rules for terminally ill

Gov. Bobby Jindal

BATON ROUGE (AP) — The Jindal administration is changing the rules to allow the terminally ill to live their final days at home, not a hospital or nursing home.
Officials say the plight of Kelvin Hudson, who was dying of terminal colon cancer, convinced them to change the rules.
Doctors refused to discharge Hudson from the hospital unless Medicaid would provide both “personal care” and “hospice care” for his end-of-life needs at home. Under the rules, Medicaid would only pay for one service or the other, but not both. The state made an exception and Hudson died at home.
Now, the administration is changing the rules for other patients in a similar predicament. About 200 terminally ill Medicaid patients annually can continue to receive services at home, so that they can die at home surrounded by family and friends.
“He was not a political person or a fighting person. He always helped someone anyway he could,” said Hudson’s sister Lydia Hudson Givens. “I’m pretty sure he’s happy he made a difference. He’s more than happy in his spirit.”
Hudson, of Baton Rouge, and his sister challenged the state hospice policy with help from The Advocacy Center after getting no relief from the state health agency.
Hospice is designed to maximize comfort for the terminally ill by reducing pain and addressing physical, psychological, social and other needs. Personal care provides basic needs when family members are at work and unavailable to provide care.
Kathy Klebery, secretary of the state Department of Health and Hospital, said the rule change will save the state an estimated $600,000 during next fiscal year because in-home hospice care costs less than that provided in a separate facility.
Nell Hahn, a lawyer with the Advocacy Center, said the state did the right thing.
Under Medicaid rules, individuals receiving home-based services through programs such as Community Choice had the option to get hospice care, Hahn said. But those getting personal care services didn’t, she said. Hahn said her agency has made comments about the disparity as hospice rules came up for review at various times during the last year.
But nothing was done until the Hudson case, she said.
The Advocacy Center, based in New Orleans, is a nonprofit corporation that serves people with disabilities, providing information, referral and at times legal representation on issues impacting them.

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